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PAINT PERMITOWNER'S NAME - a. "ifi o T . .. - . - : aial 7` J � 'PRESEPIT ADDRESS �.^� r y I T I. • 1 2 2nd St. LICENSE NO. 1226 PHONE NO. JOB LOCATION (ST. OR AVE.) 54 ::. :. 102nd St. LOT 5 e. 5 BLOCK ?a SUBDIVISION Sec. 1 GENERAL CONTRACTOR ADDRESS PHONE NO. LICENSE NO. 3436 BUILDING PERMIT NO. 3- 27 - -55 DATE 5.00 PERMIT FEE S BUILDER'S BOND 35:41 3- 27 -5') NO. DATE ZONE REQUIREMENTS CU. FT. No c'.^cn7^ in cube PLAN CUBE CU. FT. 750.00 EST. COST 5 DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: DATE NEW CONSTRUCTION TYPE STORIES ROOF CONSTRUCTION INTERIOR CONSTRUCTION REPAIRS DESCR IPTION ALTERATION DESCRIPTION ADDITION SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL REMARKS , / / ✓J CERTIFICATE OF OCCUPANCY NO.3 Y (- 2_ . ISSUED ,e.) 2� BY G', Q 6,r✓ c . L Z. e..> e..> ii / T �4 e- E TO BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION 'S/- G. -aZ 1=3,c4 'd vo S FEE TEMPORARY SERVICE DATE $ BEAMS & LINTELS S SEWER $ S SOLAR HEATER FRAMING $ GAS RANGE CONN. $ $ S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING $ FINAL /� L _ - - �: �r. J � (I SEWER CLEAN -UP SEPTIC TANK SOLAR HEATER INSPECTIONS DATE BY CONTRACTOR PHONE I PERMIT NO. f DATE FEE S NEW BLDG. ALTERATION 1 ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE DATE $ SEPTIC TANK S SEWER $ S SOLAR HEATER $ GAS RANGE CONN. $ $ S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING $ FIXTURES GAS SEWER SEPTIC TANK SOLAR HEATER INSPECTIONS DATE BY FIXTURES RE- INSPECT BY } I RE- INSPECT BY TEMP. SERVICE 1 PERMIT NO DATE FEE $ NEW BLDG. ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. S RANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY I RE- INSPECT BY } I RE- INSPECT BY TEMP. SERVICE f ROUGHING ± H. W. HEATER CON4 1 RANGE CONN. . • 1 FIXTURES & FINAL • y BUILDING INSPECTIONS • PLUMBING PERMITS at INSPECTIONS CONTRACTOR ELECTRICAL PERMITS & INSPECTIONS APPROVAL. TO POWER CO. FOR SERVICE DATE PHONE ST OWNER'S NAME D AN IELJ. CRANE PRESENT ADDRESS 129 NW 98th Street LICENSE NO. 2063 0-B PHONE NO. 78 -4254 JOB LOCATION (ST. OR AVE.) 54 NE 102nd Street LOT 5 and 6 BLOCK 11 SUBDIVISION MS #1 GENERAL CONTRACTOR Owner ADDRESS Same -. -!x PHONE NO. 78 -4254 LICENSE NO. 2063 -0 -B BUILDING PERMIT NO. 6308 Q DATE 3/15/4 PERMIT FEE $ 18.00 BUILDER'S BOND �Q NO. .680 DATE 3/ ZO NER ■6 PEQUIREMENTS 18,500 CU. FT. PLAN CUBE 21,306 CU. FT. EST. COST $ 14,500 L+ T T DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY EWStanford DATE 2/14/48 X NEW CONSTRUCTION TYPE CBS STORIES 1 ROOF CONSTRUCTION Tile Frame; INTERIOR CONSTRUCTION Oak floors; porch - tile flr. REPAIRS DESCR IPTION Liv Rm - Din Rm - Kit - Bed Rms - 2 Baths - Screened Porch ALTERATION DESCRIPTION 1 Car attached Garage Car I ADDITION PEWS) Inspecto APPROVED 1 Building SUBMITTED TO )4/4444W1/1/1/ 1 2/14/48 REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD F JRMITTED TO VILLAGE COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO. 5 ISSUED 9/34/48 JDH BY JDH TO D J Crane 129 NE 98th St BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE INSPECTIONS DATE BY RE- INSPECT BY I RE- INSPECT BY FOUNDATION 3/24148 4/6/48 REPAIRS SPECIAL PERMITS T- PERMIT NO. DATE BEAMS & LINTELS .1UH $ $ SEPTIC TANK Crane 1 6536 FRAMING $ 1.00 SEWER I $ SOLAR HEATER MOTORS $ FINAL $ S S CLEAN -L:P INSPECTIONS , DATE • RE- INSPECT ' 4/1 BY RE- INSPECT BY f �1BY y�DH CONTRACTOR Plumbing Co PHONE 7- ` McGuire PERMIT NO. 6 35 6 DATE 3/31/4 FEE $ 7.25 X NEW BLDG. X ALTERATION I ADDITION REPAIRS SPECIAL PERMITS T- PERMIT NO. DATE FEE ■ TEMPORARY SERVICE $ $ SEPTIC TANK Crane 1 6536 5/19/48 $ 1.00 SEWER I $ SOLAR HEATER MOTORS $ GAS $ S S S INSPECTIONS , DATE • RE- INSPECT ' 4/1 BY RE- INSPECT BY ROUGHING /LSO �1BY y�DH RE- INSPECT BY TEMP. SERVICE GAS k 4 ROUGHING 4/21/48, JDH SEWER I r Q JDH SEPTIC TANK 5/ JDH RANGE CONN. SOLAR HEATEF. FIXTURES FIXTURES & FINAL 1 9/13/48 JDH CONTRACTOR H ?: H Electric co Inc PHONE 78 -4634 FEES 9.80 REPAIRS PERMIT NO. I DATE 4/16/48 64/?.. NEW BLDG. X ALTERATION I ADDITION SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. S RANGE CONN. S MOTORS $ FIXTURES S $ I I INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING 4/21/48, JDH H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL 1 9/13/48 JDH BUILDING INSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE 9/13/48 BY JDH BUILDING ELECTRICAL PLUMBING Owner of Building Architect Work to be performed under this Contractor j or Builder i L C F Legal Lot !"'- ' 6 Description J 1 Address of Building MIAMI SHORES VILLAGE, FLORIDA DATE Contractor's icense No PERMIT N° 6308 Permi Subdi- vision Value of Project BY Amt. of Permit • t This permit granted to the contractor or builder named .bov to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work wil be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the o inances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and tly he umes respon- sibility for work done by his agents, servants or employees. • � ,,'•* / ` Signed. /1 it/id( c By IN In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with..11 ordinancesiaand3 regulations pejtainin thereto and in strict c formit with the plans, drawings, statements or specifications submitted to the proper authorities of Miaml'Shores Village. In acceyfing ttI9s permit I , assumq resp i for all work done by either myself, my agent, servant or employee. CONTRACTOR' OR BUILDER • AUTHORITY Ctf OCC 9/� /,/ 8 +w w� PAID BY YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER Daniol J. - Crane -W 7/974q1 1944 /c=' . O';' / J/ r .• wt 7 c=. 'f// - I. ,, /Y9 1/ /1/317yy /a- ° ° 41- a y- yEr //. 3 Fr f 5 V / -- -s „ /-//- .$ -. 0 / 4 4 . i - ' n - � �. ® -'/ s�. /4 '%( , < 4 ' <7 o f q7 - i‘ i ,2 ADDRESS 54 N.E. 102nd St. LEGAL 5, 6, Elk 11 M S S,]. RECORD GARBAGE TAX MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 -795 -2204 Building Inspection Request Date Type Insp'n Permit No. Name Address ok -t ")( • r D Company Phone # / Inspection Date to / 7 7 to Approved L� Correction /❑ Re- Insp'n Fee ❑ u4\7: a 'I Miami Shores Village SE P a '? 3 Building Department BUILDING PERMIT APPLICATION FBC 2001 Permit No. 'Q 2,O3- — 14a Master Permit No. Permit Type (circle): Building Electrical Plumbing Mechanical Roofmg 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 r Owner's Name (Fee Simple Titleholder) '%,/ ev- z / l -/` -} Phone # C `. / S 7 Owner's dress 34 / v ' ' Fe . City / AIrl> 61/0/-'t State 7L Zip % 3 O Tenant/Lessee Name Phone # Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name e; '- Phone # Contractor's Address City State Zip Qualifier Architect/Engineer's Name (if applicable) ) 0 - Phone # Architect/Engineer's Address City '� State Zip $ Value of Work For this Permit vv `' Square Footage Of Work: Number of: Bays Stories Families Bedrooms Baths Type of Work: ['Addition ['Alteration ['New ❑ Repair/Replace ❑ Demolition Describe Work: 'PA.l N 411 * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * ** * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ . CD 0 Permit Fee $ ( 0 0 "LJ Notary $ S • CD0 - Minus Plans Check Fee $ Education/Training Fee $ Tech $ Scanning $ Radon $ Code Enforcement $ Bond $ Struct. $ Total Fee Now Due $ (Continued on opposite side) Or■ C y. �2- $a),C6 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspectio ' ' ich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not e appro : d and a reinspection fee will be charged. ` 7 ,f Signature 0 weer or Agent Contractor The foregoing instrument was acknowledged before me this 3 The foregoing instrument was acknowledged before me this day of U , 20 (11 by jOhn 10i Y. , day of • , 20 by , who is personally known to me or who has produced Dry ( .z Y • who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. Signature NOTARY Sign: ( Print: np LIC: \ My Commission Expires: My Commission Expires: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ************* •#******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** an.s * * *ss *sss * * * * * * *s * * * ** *sss * * * * * * *s *.s * :ss ** * * * * ** chc7/7/03 APPLICATION APPROVED BY: `SMYpti' Mabel Vargas NOTARY PUBLIC: Commission #DD23I984' C pjtes. Jut 13, 2007 Sign: , 5 • Bonded Thru Print: ndantic Bonding, Co • Inc 4 /n - .:+. /C\ao\O3 Plans Examiner Engineer Zoning • MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: q1,10 OWNER'S NAME: db 11-0 Q "7 PHONE: 30-C Ts 4L > 757 ADDRESS: • zy a -' /0 ,,, .s-T , ******* /'o * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: 51 We- 6 r M'A; 5 _ CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the si$, must be listed and indicate the color to be painted. Walls / ©'_ .g 0 Fascia 0 Drip Cap/Drip Edge A/ Soffit kJ O Roof At v Flower Bins A o Shutters 'u o co Awnings �° r o Chimney kit) Doors and door jams JO 0 Garage Doors id 0 Railings J 0 Fences AIO Decorative Metal .10 All brick (simulated or regular) J 0 Stucco Banding h✓ 0 Any other stucco features AA Accessory Buildings AA Other Ai () samples. / g APPROVED: Building Official Date El C acho cheesi 2155 -40 a \r9 \(9 ( 3 1 o3 OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constru • ' . • and zoning. I authorize the above -named contractor, if applicable, to do the ork s , - ted. Furthe ore , the aint colors will be as per the attached Signature f • wner Date Signature of Contractor Date * * * * * * ** ************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 1CSJ neXA- .- rutcpkku MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: OWNER'S NAME: ADDRESS: ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable)_ COMPANY NAME: ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and Walls Fascia Drip Cap/Drip Edge Soffit Roof Flower Bins Shutters Awnings Chimney Doors and door jams Garage Doors Railings Fences Decorative Metal All brick (simulated or regular Stucco Banding Any other stucco features Accessory Buildings Other Building Official Date 0v - 0Z0Z g i OS - OZO � ,nn3 in3ada o � oo '— OZOZ ®3NOOW NIWVfN39 sz * * * * * ** OWNER'S AFFIDAVIT: I certify that all the for and that all work will be done in compliance with construction and zoning. I authorize the above -nai do the work stated. Furthermore the paint colors samples. 09 - 0ZOZ 3 • 0 0 OL -OZOZ Signature of Owner Date • Signature * * * ** ********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: WHEN P2 1 '2 CALL L.-- xn•AV n SrECTION J inted. c tzi 0 E c s c rn c 'c 0 E 201 8 -50 ;urate 000 ting ble, to 4/23/01 MIAMI SHORES VILLAGE Paint Color Approval and Agreement (;(--t DATE: c rffSi122--, OWNS NAME: PHONE: 1 . ADDRESS: ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: -- • lU, e472- - CONTRACTOR & LICENSE (if applicable) PHONE: COMPANY NAME: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls VOuJ - - 5 wee p er 'Z Fascia 1 )\ 1 ' • x , 11 Drip Cap/Drip Edge Soffit Roof Flower Bins KYTh j Shutters Awnings 0 Chimney Q3C� Doors and door jams i•�C.� Garage Doors Railings - Fences Decorative Metal All brick (simulated or regular) kDC Stucco Banding C) Any other stucco features Accessory Buildings 1 )C.) Other Building OrficiaY Date 180 OWNER'S AFFIDAVIT: I certify that all the foregoing information a regulating and that all work will be done in compliance with all applicable l a if a to construction and zoning. I authorize the above named do the work stated. Furthermore the paint colors will be as per the attached samples. Signature of 0 - Date Signature * * * * Contractor * * * * * * * * * * *D * * * * * * * ** APPROVED: WHEN PAINTING CALL FOR FINAL INSPECTION 4/23/01 MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: OWNER'S NAME: PHONE: ADDRESS: *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls (t2GkOW Fascia .1JD/1/ 14-2. Drip Cap/Drip Edge 13IO }P. 1,, Soffit (�,1 V1 t 1•Q Roof Flower Bins Shutters Awnings Chimney Doors and door jams Garage Doors Railings Fences Decorative Metal All brick (simulated or regular) Stucco Banding Any other stucco features Accessory Buildings Other OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I authorize the above -named contractor, if applicable, to • • he i ork st ed. Furthermore , the paint colors will be as per the attached sl:, .4► „':�I 0 4 ?) (67. ( Si • ture f Owner Date • Signature of Cont actor Date ** ****************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** • ' 'ROVED: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 0 2E sweet butter cn Building Official Date 4/23/01 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 3 Job Address Tax Folio Legal Description Historically Designated: Yes Owner/Lessee / Tenant JQ AleJ £ / Ti • Master Permit # 4 /0 Architect/Engineer N a Address Bonding Company Address WORK DESCRIPTION / GL Square F ( - � Ft. c= Q 0 Signature of o r and/or Condo Presii:ent Date Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMI RADON APPROVED: Zoning Building Mechanical Plumbing s� fq31,7 Phone Sta Estimated Cost (value) Phone 2/D Signature of ' on - tor or Owner -Buil I�fotary as to Contractor or Owner - Builder My Commission Expires: Electrical Owner's Address V A 1 • E /O Contracting Co. I Address Qualifier SS# State # Municipal # / &n' competency # ;o. Mortgagor Address Permit Type (circle one): BUILDING ELECT ' CAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER' . _ IDAVIT: I certify that all the foregoing information accurate and tha : 1 work will be done in compliance with all applicable laws re _ ating c. struction and zoning. Furthermore, I authorize the bove -named contracto to do the work stated. Date Date .3 i`t C.C.F. • NOTARY 1 BOND TOTAL DU '!lite;.' -`- e56c) Engineering Present Zoning R -15 Council Action Required NO Council Action c7 1 Liami JI2ores9111.age F L O R I O A PLANNING BOARD AGENDA OF March 27,1997 ITEM NO. 3 Name of Owner /Applicant John R. Toth Phone No. 754-1757 Name of Architect/Contractor Phone No. Address of Property, and/or Legal Description 54 N.E. 10 2 St. Nature ofRequest Appeal of Building Official disapproval of house color. Area of Present Building Area of Proposed Addition Total Area Parking Spaces Provided Parking Spaces Required with Addition Setbacks as per Code : Front Side Rear Setbacks Provided : Front Side Rear Variances/Zoning Change NONE Section 533 (Quality of Building Generally) Planning Board Action 6e),"('04/ Director of Building and Zoning DIVISION 7. QUALITY OF BUILDINGS Section 523. [Quality of buildings generally.] All buildings shall be generally harmonious in character and appearance, including exterior color, with existing buildings in the neighborhood and shall be appropriate to their surroundings. In the event that an application is made for a building permit for the construction of a building, or the performance of work on an existing building, that, prima facie, would be inharmonious or inappropriate in the manner indicated above, such permit shall not be issued except on recommendation by the planning board and approval by the village council, as provided in Article VI. (Ord. No. 503, § 2, 1 -6-87) MAR -18 -97 TUE 03:58 PM TCI'MIAMI LAKES Memorandum DATE: March 18, 1997 TO: FROM: To whom it may concern; Village of Miami Shores; The Planning and Zoning Board John R. Toth 54 N.E. 102nd Street Miami Shores, Fl. 33138 Last week, I submitted to the Village of Miami Shores; the Planning and Zoning Department a paint sample for the outside of my home. (Home Depot/Corn Burst, a pale yellow) This color sample was not approved. What was approved by the Planning and Zoning Department was a Benjamin Moore Paint 2 -0 305. This recommended color is a softer yellow and with my current white tile roof and white wall I feel that this may take away from the aesthetic look of the home and of the area. I would like for the Planning Board to review my orginal sample for approval. Once again I appreciate your understanding in this matter. 3058196852 P.02 • . Date f✓ 7 Job Addres Legal Description /2 �• Owner / Lessee Owner's Address Contracting Co. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE - / Tenant Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: '1,!I/ /II 4.: / a/110 r - 2 a t) Master Permit # 36 r // c2 (.57:/= Phone 7O7 Qualifier SSO - State # Municipal # Competency 4 Architect /Engineer Bonding Company Mortgagor Permit Type(circle one • BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING WORK DESCRIPTION 1i ' J t Att '-f 4 »(2 Square Pt. Zoning Building qR Mechanical Plumbing Address Estimated Cost(value) /a0, WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stat-d. r • _.. L . }' -.SEAL GALE E NOWELL NOTARY PUBLIC STA CE OF FLORIDA Cl?ICMISSIOPit NO. CC? 3955 MY COMMISSION MISSION EXP. DEC. 5,1997 Signat Date: My ** * * * * * * * * * ‘ 7 1 FEES: PERMIT ■ v /1 RADON C.C.F. , 5v NOTARY APPROVED: Fire Tax Folio H"3° D/3 -)1 Phone ,Co. Other PAVING FENCE SIGN e of Con r:c or or Owner- Builder K.L.c1)..,L - (C: IR F_ E A)c t tF( l, otary as to Contractor or Owner- Builder TOTAL Electrical Engineering r I - .